What future the cane industry: is training a vehicle for change?

This paper summarised research into the training needs of cane growers in Queensland and Northern New South Wales for the Sugar Research and Development Corporation (SRDC). The full report supplied comprehensive insights into industry training needs from the perspective of those most directly involved in the production side. As a result of historically low price returns and in some areas, lingering effects of lower than average rainfall, many cane growers are faced with difficult prospects: exiting the industry, seeking to augment incomes by off-farm employment, or diversifying their farming operations. Prior research has shown that farmers undertaking training in other farm business sectors have markedly higher gross operating surpluses when compared with those who did not train. Findings from this research revealed a significant unrecognised demand for competency-based training and a need for adoption strategies to be developed and championed at a whole of industry level. By adopting lessons learnt from other industry re-structures, cane growers can maintain their viability from high-level business management training which is not currently offered. The industry is challenged by a need to engage multiple stakeholders and to develop client designed training programs to enable them to remedy farming-related problems

Treatment or surveillance for CIN2? : Women now have better data on regression and progression to help them decide

Acknowledgments Jaimie Kavanagh reviewed and contributed to this editorial as a patient representative and volunteer for Jo’s Cervical Cancer Trust.Non peer reviewedPublisher PD

Women’s Preferences for Communication with the Cervical Screening Programme : A Qualitative Study

ACKNOWLEDGEMENTS This research took place in the University of Aberdeen and NHS Grampian, Aberdeen, UK. We are grateful to the women who participated in our study and the NHS staff at the Women's Day Clinic in Aberdeen Royal Infirmary for their support. Funding was obtained from NHS Grampian Endowment fund for summer studentship.Peer reviewedPostprin

Information needs of young women vaccinated against HPV attending colposcopy : a qualitative study

Acknowledgements The University of Aberdeen and Aberdeen Royal Infirmary for the opportunity to undertake research at an undergraduate level. We are grateful to all the women who took part in this study. Funding The University of Aberdeen provides a small sum of money to support medical students carrying out research projects but was not involved in the design of the study, data collection, analysis and interpretation or writing the manuscript. AY attended the University of Aberdeen at the time this study was undertaken.Peer reviewedPublisher PD

Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study

The manuscript was reviewed by Jo’s Trust, which supports the conclusions. It made the following statement: We think (it has) massive implications for the screening programme, vaccine and also impact on diagnoses in the future. It gives weight for activity to increase vaccine uptake, has implications on screening intervals. The clinically relevant herd protection is very interesting too. It also feeds into our policy calls for a new IT infrastructure (for the screening programme in England) to record and enable invitations based on whether someone has at the vaccine if intervals can be extended. Funding: This study has been undertaken as part of the programme of surveillance of immunisation against human papillomavirus in Scotland, included within the routine work of Health Protection Scotland, a part of the Scottish National Health Service. No funding has been received from industry.Peer reviewedPublisher PD

Exploring Opinions and Concerns about the Human Papillomavirus Vaccine on a United Kingdom Online Discussion Forum

Peer reviewedPublisher PD

An integrative approach to evaluating the implementation of social and emotional learning and gender-based violence prevention education

Evaluation studies often use stand-alone and summative assessment strategies to examine the impacts of Social and Emotional Learning (SEL) and Gender-based Violence (GBV) prevention education programs. However, implementation research is yet to offer an integrative framework that can be used to investigate the implementation drivers that lead to the uptake of programs that pursue SEL and GBV prevention agendas. We address this gap in research by presenting a framework developed to investigate factors affecting the implementation of the Resilience, Rights and Respectful Relationships program, an SEL and GBV prevention education program developed for primary and secondary schools in the state of Victoria, Australia. Drawing upon and advancing a conceptual framework for implementation fidelity proposed by Carroll and colleagues we discuss the iterative process designed to investigate the individual, school and system level factors within the wider political and ideological setting(s) of the program that impact on its implementation. Within this iterative process, we highlight the need to focus on ‘the ecology of relations’ that exists between various implementation elements, and their possible mediating impact on program delivery, uptake and outcomes.peer-reviewe

Psychosocial impact of alternative management policies for low-grade cervical abnormalities : results from the TOMBOLA randomised controlled trial

Background: Large numbers of women who participate in cervical screening require follow-up for minor cytological abnormalities. Little is known about the psychological consequences of alternative management policies for these women. We compared, over 30-months, psychosocial outcomes of two policies: cytological surveillance (repeat cervical cytology tests in primary care) and a hospital-based colposcopy examination. Methods: Women attending for a routine cytology test within the UK NHS Cervical Screening Programmes were eligible to participate. 3399 women, aged 20–59 years, with low-grade abnormal cytology, were randomised to cytological surveillance (six-monthly tests; n = 1703) or initial colposcopy with biopsies and/or subsequent treatment based on colposcopic and histological findings (n = 1696). At 12, 18, 24 and 30-months post-recruitment, women completed the Hospital Anxiety and Depression Scale (HADS). A subgroup (n = 2354) completed the Impact of Event Scale (IES) six weeks after the colposcopy episode or first surveillance cytology test. Primary outcomes were percentages over the entire follow-up period of significant depression (≥8) and significant anxiety (≥11; “30-month percentages”). Secondary outcomes were point prevalences of significant depression, significant anxiety and procedure-related distress (≥9). Outcomes were compared between arms by calculating fully-adjusted odds ratios (ORs) for initial colposcopy versus cytological surveillance. Results: There was no significant difference in 30-month percentages of significant depression (OR = 0.99, 95% CI 0.80–1.21) or anxiety (OR = 0.97, 95% CI 0.81–1.16) between arms. At the six-week assessment, anxiety and distress, but not depression, were significantly less common in the initial colposcopy arm (anxiety: 7.9% vs 13.4%; OR = 0.55, 95% CI 0.38–0.81; distress: 30.6% vs 39.3%, OR = 0.67 95% CI 0.54–0.84). Neither anxiety nor depression differed between arms at subsequent time-points. Conclusions: There was no difference in the longer-term psychosocial impact of management policies based on cytological surveillance or initial colposcopy. Policy-makers, clinicians, and women themselves can be reassured that neither management policy has a significantly greater psychosocial cost

HPV Testing in the context of post-treatment follow up (test of cure)

&lt;p&gt;&lt;b&gt;BACKGROUND: &lt;/b&gt;Women treated for cervical lesions are at higher risk of subsequent disease compared to the general population. Consequently, post treatment surveillance strategies are required to ensure the success of treatment, so called &quot;test of cure&quot;. The high sensitivity and negative predictive value of HPV assays can enhance post-treatment strategies.&lt;/p&gt;&lt;p&gt;&lt;b&gt;OBJECTIVES: &lt;/b&gt;To provide an overview of the current data on test of cure strategies with a particular focus on HPV testing and to identify knowledge gaps and areas for further research.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS: &lt;/b&gt;HPV testing is sensitive for the detection of residual or recurrent disease post treatment for CIN2+ and is more sensitive than cytology alone. Co-testing increases sensitivity, marginally and there is a lack of consensus regarding the efficiency and safety to release negative women. Most test of cure studies have applied HPV DNA tests and post treatment positivity rates vary widely depending on assay and potentially, treatment type.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSIONS: &lt;/b&gt;Globally, an increasing number of test of cure algorithms now incorporate HPV testing although there is heterogeneity of practice with respect to assay, number of post treatment tests, testing intervals, follow up time. While type specific persistence identified through genotyping may identify those at greater risk of disease there is no consensus as to how this may be applied, clinically. Data on HPV testing in women treated for glandular lesions would be welcome as would the performance of different HPV assays and associated biomarkers in this context.&lt;/p&gt;</p